Laboratory Studies

No specific laboratory studies, imaging, or diagnostic procedures are required in the evaluation of microstomia. However, any systemic abnormalities that result from the underlying cause of the microstomia may affect the patient's ability to heal from the inciting event or to undergo anesthesia and surgery; thus, such systemic abnormalities should be sought. For example, patients with electrical burns should undergo an ECG because myocardial injuries, conduction abnormalities, or both are possible and must be promptly diagnosed. Computerized tomography or radiography of the chest may be useful in patients with scleroderma for determining the presence of pulmonary fibrosis. Endoscopic evaluation of the airway should be considered in patients with microstomia due to epidermolysis bullosa.

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Other Tests

ECG is appropriate in cases of electrical burns because myocardial injuries, conduction abnormalities, or both are possible and must be promptly diagnosed.

Converse JM. Technique for elongation of the oral fissure and restoration of the angle of the mouth. Kazanjian VH, Converse JM, eds. The surgical treatment of facial injuries. Baltimore; Williams and Wilkins;1959. p. 759.

Child with craniofacial anomalies and microstomia. A tracheotomy is in place for airway control because of micrognathia. Advancement osteotomies have been performed in an effort to lengthen the mandible.

Commissuroplasty, as performed by Gillies and Millard (1957). (A) Triangular skin excision designed to accommodate elongation of the commissure. A flap of vermilion is raised from the lower lip. (B) Vestibular mucosa is advanced externally to reconstruct the vermilion of the lower lip. (C) The vermilion flap is rotated and sutured laterally to reconstruct commissure. (Reprinted from Converse JM and Wood-Smith D. Techniques for repair of defects of the lips and cheeks. In Converse JM, ed. Reconstructive Plastic Surgery, 2nd edition, volume 3. WB Saunders; Philadelphia:1977. pp.1575, with permission from Elsevier).

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;Cliexa;The Physicians Edge;Sync-n-Scale;mCharts<br/>Received income in an amount equal to or greater than $250 from: The Physicians Edge, Cliexa<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; .

Additional Contributors

Hassan H Ramadan, MD, MSc Professor and Vice-Chair, Department of Otolaryngology-Head and Neck Surgery, Professor, Department of Pediatrics, West Virginia University School of Medicine